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      Towards a smoke-free world? South America became the first 100% smoke-free subregion in the Americas Translated title: ¿Hacia un mundo libre de humo? América del Sur se convierte en la primera subregión 100% libre de humo en la Región de las Américas Translated title: Rumo a um mundo livre de fumo? A América do Sul tornou-se a primeira sub-região 100% livre de fumaça de tabaco nas Américas

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          ABSTRACT

          Almost 20 years after the launching by the Pan American Health Organization of its “Smoke-Free Americas” initiative in 2001, in December 2020, South America became the first subregion in the Americas to accomplish 100% smoke-free environments in line with Article 8 of the World Health Organization Framework Convention on Tobacco Control (FCTC). Some of these countries adopted legal measures that are more robust than others, including in their laws specific outdoor places in the smoking ban (like Argentina and Uruguay) and/or novel nicotine and tobacco products under their scope (like Ecuador and Paraguay). The 10 countries took different paths to adopt this public health measure, either through executive or legislative measures or a combination of both. A few countries, like Argentina, Brazil, and Venezuela, started at the subnational level and then moved on to the national level, similar to the rest of the countries.

          For achieving this milestone, an adequate context was crucial: the broad ratification of the FCTC and the relevance given to the human right to health, civil society efforts, commitments made by intergovernmental bodies, media and communication strategies, and the development of scientific evidence. Countries faced obstacles, including the well-known interference of the tobacco industry, which among other strategies used litigation; however, courts and judges upheld comprehensive legal measures on smoke-free environments.

          The process by which South America achieved this milestone represents a role model for other subregions of the Americas and the world.

          RESUMEN

          Casi 20 años después del lanzamiento de la iniciativa "América libre de humo" de la Organización Panamericana de la Salud en el año 2001, en diciembre del 2020, América del Sur se convirtió en la primera subregión de la Región de las Américas en lograr que 100% de los entornos sean libres de humo, en consonancia con el Artículo 8 del Convenio Marco para el Control del Tabaco de la Organización Mundial de la Salud (CMCT). Algunos de países de la subregión adoptaron medidas legales más sólidas e incluyeron en su legislación la prohibición de fumar en lugares al aire libre concretos (como Argentina y Uruguay) o de introducir nuevos productos de nicotina y tabaco en su alcance jurídico (como Ecuador y Paraguay). Los diez países tomaron diferentes caminos para adoptar esta medida de salud pública, ya fuera mediante disposiciones ejecutivas, legislativas o una combinación de ambas. Algunos países, como Argentina, Brasil y Venezuela, empezaron a nivel subnacional y luego, de un modo similar al del resto de países, pasaron al nivel nacional.

          Para lograr este hito fue crucial un contexto adecuado: una amplia ratificación del CMCT y la relevancia dada al derecho humano a la salud, los esfuerzos de la sociedad civil, los compromisos asumidos por los órganos intergubernamentales, los medios y las estrategias de comunicación, y el progreso de la evidencia científica. Los países se enfrentaron a obstáculos, entre ellos la conocida interferencia de la industria tabacalera, que entre otras estrategias empleó el uso de litigios; sin embargo, distintos tribunales y jueces respaldaron medidas legales integrales de ambientes libres de humo de tabaco.

          El proceso mediante el cual América del Sur ha logrado este objetivo representa un modelo a seguir para otras subregiones de las Región de las Américas y el mundo.

          RESUMO

          Em dezembro de 2020, quase 20 anos depois do lançamento da iniciativa “Américas sem Fumo” pela Organização Pan-Americana da Saúde, em 2001, a América do Sul tornou-se a primeira sub-região das Américas a alcançar ambientes 100% livres de fumaça de tabaco, em conformidade com o Artigo 8 da Convenção-Quadro para o Controle do Tabaco da Organização Mundial da Saúde (CQCT). Alguns desses países adotaram medidas legais mais robustas que outros, com a inclusão da proibição de fumar em determinados locais ao ar livre (como Argentina e Uruguai) e/ou de novos produtos de nicotina e tabaco no escopo de suas leis (como Equador e Paraguai). Os dez países seguiram caminhos diferentes ao adotarem essa medida de saúde pública, por meio de medidas executivas ou legislativas ou ainda por uma combinação de ambas. Alguns países, como Argentina, Brasil e Venezuela, começaram no âmbito subnacional e depois passaram ao âmbito nacional, de maneira semelhante aos demais países.

          Para alcançar esse marco, foi crucial ter um contexto adequado: a ampla ratificação da CQCT, bem como a importância dada ao direito humano à saúde, os esforços da sociedade civil, os compromissos assumidos por organismos intergovernamentais, as estratégias de mídia e comunicação e o desenvolvimento de evidências científicas. Os países enfrentaram obstáculos, incluindo a conhecida interferência da indústria do tabaco, que, entre outras estratégias, recorreu ao litígio; entretanto, os tribunais e juízes mantiveram medidas legais abrangentes sobre ambientes livres de fumo.

          O processo pelo qual a América do Sul alcançou esse marco constitui um exemplo para outras sub-regiões das Américas e para o mundo.

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          Most cited references42

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          Thirdhand Smoke: New Evidence, Challenges, and Future Directions.

          Thirdhand smoke (THS) is the contamination that persists after secondhand tobacco smoke has been emitted into air. It refers to the tobacco-related gases and particles that become embedded in materials, such as the carpet, walls, furniture, blankets, and toys. THS is not strictly smoke, but chemicals that adhere to surfaces from which they can be released back into the air, undergo chemical transformations and/or accumulate. Currently, the hazards of THS are not as well documented as the hazards of secondhand smoke (SHS). In this Perspective, we describe the distribution and chemical changes that occur as SHS is transformed into THS, studies of environmental contamination by THS, human exposure studies, toxicology studies using animal models and in vitro systems, possible approaches for avoiding exposure, remediation of THS contamination, and priorities for further research.
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            WHO report on the global tobacco epidemic, 2021: addressing new and emerging products

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              WHO report on the global tobacco epidemic 2021: addressing new and emerging products

              (2021)
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                Author and article information

                Journal
                Rev Panam Salud Publica
                Rev Panam Salud Publica
                rpsp
                Revista Panamericana de Salud Pública
                Organización Panamericana de la Salud
                1020-4989
                1680-5348
                10 May 2022
                2022
                : 46
                : e103
                Affiliations
                [1 ] normalizedCampaign for Tobacco-Free Kids Washington, D.C. United States of America originalCampaign for Tobacco-Free Kids, Washington, D.C., United States of America.
                [2 ] normalizedPan American Health Organization Washington, D.C. United States of America originalPan American Health Organization, Washington, D.C., United States of America
                [3 ] normalizedInternational Union Against Tuberculosis and Lung Disease Paris France originalInternational Union Against Tuberculosis and Lung Disease, Paris, France
                Author notes
                Article
                RPSP.2022.103
                10.26633/RPSP.2022.103
                9534353
                36211249
                a2371865-4e29-4996-92dd-be2736a22457

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL. Open access logo and text by PLoS, under the Creative Commons Attribution-Share Alike 3.0 Unported license.

                History
                : 15 December 2021
                : 14 March 2022
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 35
                Funding
                Funded by: Bloomberg Initiative to Reduce Tobacco Use;
                GS, PS, PG, EMS, GSo, and VV received funding from the Bloomberg Initiative to Reduce Tobacco Use. The Bloomberg Initiative has not played a role in the conduct of the research or the preparation of this article.
                Categories
                Special Report

                smoke-free environments,tobacco smoke pollution,health policy,south america,ambientes libres de humo,contaminación por humo de tabaco,política de salud,américa del sur,ambientes livres de fumo,poluição por fumaça de tabaco,política de saúde,américa do sul

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